Purpose: Implantation of urinary sphincter systems in children is seldom in
dicated. The primary indication is neurogenic bladder, and in some cases, c
ongenital anomalies. We analyzed the postoperative results after implantati
on of the AMS 800(R) artificial urinary sphincter in a consecutive series o
f children with severe incontinence.
Materials and Methods: We performed 15 sphincter implantations in children
aged 8-17 years with urinary incontinence; 12 due to neurogenic causes and
3 with bladder exstrophy or epispadias.
Results: There were 28 complications in the 15 patients; in 7 a reoperation
was necessary. Serious complications requiring removal of the system inclu
ded 2 with cuff decubitus and one with scrotal infection. One of these unde
rwent subsequent successful reimplantation. Despite relatively frequent pro
blems with postoperative activation of the system. 12 patients reported cli
nical improvement with urinary continence confirmed by urodynamic testing.
Conclusion: Those children who underwent successful implantation of a urina
ry sphincter system (12 of 15 in this consecutive series) reported signific
ant improvement in quality of life with urodynamic confirmation of urinary
continence.